肌萎缩侧索硬化的睡眠进程和结构改变及相关因素研究

发布时间：2018-03-29 14:48

本文选题：肌萎缩侧索硬化　切入点：多导睡眠图　出处：《南昌大学》2014年硕士论文

【摘要】：目的：探讨肌萎缩侧索硬化（ALS）患者夜间睡眠进程和睡眠结构的改变及其相关因素。方法：应用多导睡眠图（PSG），对40例ALS患者（研究组）和40例健康体检者（对照组）进行夜间睡眠进程和睡眠结构检测，比较两组相关检测指标的差异，并进行ALS患者睡眠进程和睡眠结构改变的相关因素分析。结果：（1）研究组与对照组相比，总睡眠时间（TST）明显缩短（P＜0.001），睡眠效率（SE）明显降低（P＜0.001），觉醒期（WASO）明显延长（P＜0.001）；睡眠潜伏期（SL）和觉醒次数（AT）有延长、增加趋势，但不显著（P＞0.05）。（2）研究组和对照组相比，S2期睡眠、S3期睡眠及快速眼动期（REM）睡眠均明显缩短（分别P＜0.001、P＜0.001、P＜0.05）；S1期睡眠延长不显著（P＞0.05）。（3）研究组睡眠进程改变的相关因素分析显示，患者年龄与TST呈负相关（r＝-0.312，P＝0.05），患者最低血氧饱和度（SpO2）与TST呈正相关（r＝0.328，P＜0.05），患者体重指数（BMI）、病程长短、综合医院抑郁量表（HADSd）评分、综合医院焦虑量表（HADSa）评分、改良肌萎缩侧索硬化功能量表（ALSFRS-R）评分、睡眠呼吸暂停/低通气指数（AHI）和平均SpO2与TST均无直线相关（P＞0.05）；上述相关因素与患者SL、SE、AT均无直线相关（P＞0.05）；患者年龄与WASO呈正相关（r＝0.335，P＜0.05），其余相关因素与WASO无直线相关（P＞0.05）。（4）研究组睡眠结构改变的相关因素分析显示，患者病程长短与S2期睡眠呈负相关（r＝-0.337，，P＜0.05），患者ALSFRS-R评分和最低SpO2与S2期睡眠呈正相关（分别r＝0.319，P＜0.05和r＝0.338，P＜0.05），患者年龄、BMI、HADSd评分、HADSa评分、AHI、平均SpO2与S2期睡眠无直线相关（P＞0.05）；患者年龄与REM期睡眠呈负相关（r＝-0.549，P＜0.05），其余相关因素与REM期睡眠无直线相关（P＞0.05）；上述相关因素与S1期睡眠和S3期睡眠均无直线相关（P＞0.05）。结论：ALS患者存在明显睡眠进程和睡眠结构的改变，患者年龄、病程长短、病情程度和最低SpO2等可能是主要相关因素。PSG应作为ALS患者常规评估手段。
[Abstract]:Objective: to investigate the changes and related factors of sleep process and sleep structure in patients with amyotrophic lateral sclerosis (ALS). Methods: 40 patients with ALS (study group) and 40 healthy controls (control group) were tested for sleep progression and sleep structure by using polysomnography (PSG), and the differences between the two groups were compared. The related factors of sleep process and sleep structure changes in patients with ALS were analyzed. Results compared with the control group, the total sleep time (TST) of the study group was significantly shorter than that of the control group (P < 0.001), the sleep efficiency was significantly decreased (P < 0.001), the wakefulness phase was significantly prolonged (P < 0.001), the sleep latency (SLT) and the number of awakenings (ATT) were increased. But there was no significant difference between the study group and the control group (P > 0.05, P > 0.05, P > 0.05, P > 0.05). Compared with the control group, the sleep duration of the study group was significantly shorter than that of the control group (P < 0.001, P < 0.001, P < 0.001, P < 0.05, P > 0.05, P > 0.05, P > 0.05, respectively). There was a negative correlation between age and TST, and there was a positive correlation between the minimum oxygen saturation (SPO _ 2) and TST (P < 0.05), body mass index (BMI), duration of disease, general hospital depression scale (HADSdD), and general hospital anxiety scale (HADSa). Modified amyotrophic lateral sclerosis scale (ALSFRS-R) score; Sleep apnea / hypopnea index (AHII) and average SpO2 had no linear correlation with TST (P > 0.05); there was no linear correlation (P > 0.05); age was positively correlated with WASO 0.335 (P < 0.05); other related factors had no linear correlation with WASO (P > 0.05). Analysis of the related factors of sleep structure changes in group A showed that, There was a negative correlation between duration of disease and sleep in S2 stage (P < 0.05). The ALSFRS-R score and minimum SpO2 were positively correlated with sleep in S2 stage (r = 0.319, P < 0. 05, P < 0. 05, P < 0. 05, P < 0. 05, P < 0. 05, P < 0. 05, P < 0. 05, P < 0. 05, P < 0. 05, respectively). There was no linear correlation between average SpO2 and sleep in S2 stage (P > 0. 05), and there was no linear correlation between age and age (P > 0. 05). There was a negative correlation between REM sleep and REM sleep (P < 0.05), but there was no linear correlation between the other factors and REM sleep (P > 0.05), but there was no linear correlation between the above factors and S1 stage sleep and S3 stage sleep (P > 0.05). Conclusion there are significant changes in sleep process and sleep structure in patients with ALS. Age, duration of disease, severity of disease and minimum SpO2 may be the main related factors. PSG should be used as a routine evaluation method for ALS patients.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R744.8

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